OBJECTIVES: To determine the proportion of children who
meet the clinical criteria for the diagnosis of sinusitis among
all children attending primary care pediatric practices, to
explore the relationship between passive smoking and the
occurrence of sinusitis and to study the role of antibiotics in
the management of sinusitis.
DESIGN: A prospective observational cohort study.
SETTING: Outpatient Pediatric Clinics of Jordan
University of Science and Technology and Princess Rahma Teaching
Hospital. Patients. All children ages 1 to 10 years presenting
for any reason to participating practices.
METHODS: Physicians participating in this study completed
a questionnaire on all children attending the primary care
centers, detailing the presence of nasal congestion or
discharge, the duration of symptoms, daytime cough and whether
symptoms were improving. The presence or absence of smokers in
the family was also recorded. Children meeting our clinical
criteria for sinusitis were further evaluated for other signs
and symptoms including the type of medication prescribed. The
severity of symptoms was reassessed at 10-day follow-up after
the first visit.
RESULTS: The study population was composed of 3001
children, of whom 249 met our clinical criteria for diagnosis of
sinusitis (8.3%; 95% confidence interval, 7.3 to 9.3%). The
prevalence rate of clinical sinusitis was greater among children
age 5 years and older than among those younger (9.3% vs. 7.2%, P
= 0.04). Children exposed to passive smoking in the household
had clinical sinusitis significantly more than those not exposed
(68.8% vs. 1.2%, P = 0.00). Antibiotics were prescribed for 80%
of children who fulfilled the clinical criteria for diagnosis of
sinusitis. Marked improvement of symptoms at the 10-day
follow-up visit was reported among those who received
antibiotics compared with those who did not (91% vs. 21.4%, P =
CONCLUSIONS: Sinusitis is not an uncommon problem in
children, passive smoking might be a contributing factor and a
course of antibiotic therapy is beneficial.
Department of Pediatrics, Jordan University of Science and